Erin M. Neal

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries, including a concussion and pre-existing spinal conditions, warranted removal from the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to provide compelling medical evidence from a qualified physician to support a concussion diagnosis or demonstrate that a pre-existing condition precluded recovery under the MIG.

The Tribunal also denied a $755.00 claim for physiotherapy services, finding the insurer's denial notice complied with the Schedule.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied two treatment plans for chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant sought removal from the MIG based on a pre-existing condition and chronic pain.

The Tribunal found the applicant failed to prove her injuries fell outside the MIG, as she did not provide compelling evidence that her pre-existing conditions prevented maximal recovery within the MIG, nor did she establish chronic pain with functional impairment.

As the MIG limit was exhausted, the treatment plans were denied.

Claims for interest and a special award were also dismissed.

The applicant sought various statutory accident benefits following a 2017 motor vehicle accident, including treatment plans for physiotherapy, occupational therapy, a chronic pain assessment, and catastrophic impairment assessments.

The respondent denied the benefits.

The Tribunal found that the respondent's notices of denial were compliant with the Statutory Accident Benefits Schedule.

On the merits, the Tribunal held that the applicant failed to prove the treatment plans were reasonable and necessary, noting that the applicant's cognitive impairments were pre-existing and that she had reached maximal medical recovery for her accident-related physical injuries.

The application was dismissed.

The applicant passed away prior to the commencement of an application for statutory accident benefits.

The application was commenced by counsel without an estate trustee having been appointed.

The Licence Appeal Tribunal found that the application was not properly constituted and was an irremediable nullity, as a deceased person cannot pursue accident benefits and no lawfully authorized representative was appointed.

The application was dismissed as an abuse of process, and the respondent's request for costs was denied.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied income replacement benefits, arguing the applicant was barred under s. 31(1)(b) of the Schedule for intentionally failing to notify it of his move from Kitchener to Toronto, which would have increased his premiums.

The Tribunal found that while the address change was a material risk, the respondent failed to meet its burden of proving the failure to disclose was intentional.

The applicant testified he informed his broker of the move, and the respondent provided insufficient evidence to refute this.

The applicant is not barred from proceeding with his claim.

The applicant sought entitlement to various treatment plans and a SPECT scan following a 2017 motor vehicle accident.

The applicant argued the treatment plans were payable because the insurer failed to provide compliant denials within 10 days under s. 38 of the Schedule.

The Tribunal found the insurer's denials were timely and compliant.

On the merits, the Tribunal held the treatment plans were not reasonable and necessary, relying on insurer examinations that found the applicant had adequate functional abilities and no ongoing cognitive impairments.

The SPECT scan was denied as it was submitted beyond the 260-week limitation period.

The application was dismissed.

The respondent insurer requested a reconsideration of a decision awarding the applicant entitlement to chiropractic and physiotherapy services, interest, and an award under the Schedule.

The respondent argued the adjudicator made errors of law and fact and breached procedural fairness by finding its denials non-compliant and penalizing its failure to obtain updated medical assessments.

The adjudicator dismissed the request, finding no significant legal or evidentiary mistakes, and held that the original decision correctly addressed the non-compliant denials and unreasonable delay in treatment.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically the unapproved balance of a physiotherapy treatment plan.

The insurer had approved 60-minute sessions but denied funding for an additional 90 minutes per session and transportation expenses.

The Tribunal found that the applicant was not entitled to the benefits by operation of section 38(11) of the Schedule because no unapproved goods or services were incurred during the period of the insurer's non-compliance.

Furthermore, the applicant failed to demonstrate that the transportation expenses or the extended treatment sessions were reasonable and necessary.

The application was dismissed, along with claims for interest and an award.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish that his physical or psychological impairments warranted removal from the MIG.

The Tribunal also found that the respondent was compliant with the response requirements under s. 38 of the Schedule.

The application for disputed treatment plans, interest, and an award was dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident.

The Tribunal found that the applicant was not entitled to the disputed physiotherapy, massage, and orthopaedic assessment plans, as they were not shown to be reasonable and necessary.

However, the Tribunal ordered the respondent to pay for two incurred treatment plans for chiropractic and physiotherapy services because the respondent's denial notices failed to comply with s. 38(8) of the Schedule.

The Tribunal also granted a 25% award under s. 10 of O. Reg. 664 on the incurred plans, finding the respondent's conduct in relying on an IE that did not address the disputed plans to be imprudent and inflexible.

The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic treatment and massage therapy under the Statutory Accident Benefits Schedule.

The respondent denied the treatment plans based on insurer's examinations and surveillance evidence.

The applicant applied to the Licence Appeal Tribunal to dispute the denials and sought an award for unreasonable delay.

The Tribunal found that the applicant failed to prove the proposed treatment plans were reasonable and necessary, noting that the applicant had recovered much of his pre-accident functional abilities and that there were more effective alternatives for pain relief.

The Tribunal also found that the respondent provided sufficient medical reasons for its denials in compliance with section 38(8) of the Schedule.

The application was dismissed.

The respondent insurer brought a motion to dismiss the applicant's claim for attendant care benefits, arguing she failed to comply with section 46.2(1) of the Statutory Accident Benefits Schedule by not providing requested information, including tax returns of her service provider.

The Tribunal found that the applicant had provided sufficient information to determine the incurred benefits, including a breakdown of services and the provider's curriculum vitae.

The Tribunal held that the requested tax returns were not relevant to proving the benefits were incurred.

The motion was dismissed, and the applicant was permitted to proceed to a hearing.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied a treatment plan for $3,353.40 on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued the denial lacked sufficient medical reasons under s. 38(8) of the Schedule and that he suffered from chronic pain warranting removal from the MIG.

The Tribunal found the respondent's denial was compliant and that the applicant failed to provide sufficient evidence of chronic pain causing functional impairment.

The application was dismissed.

The applicant sought medical benefits for three chiropractic treatment plans following a motor vehicle accident.

The respondent denied the plans, relying in part on an insurer's examination report.

The Tribunal found that the respondent's denial notices failed to comply with section 38(8) of the Statutory Accident Benefits Schedule because they lacked specific medical reasons and relied on an examination report that did not address the specific treatment plans in dispute.

As a result of the defective notices, the respondent was ordered to pay for the treatment plans pursuant to section 38(11).

The Tribunal also awarded interest on the overdue benefits and a 25% special award due to the respondent's unreasonable delay and failure to properly adjust the file.

The appellant appealed a decision allowing her long-term disability (LTD) insurer to deduct the amount of a Non-Earner Benefit (NEB) she received from her auto insurer following a second accident.

The appellant argued that based on the 'apples to apples' principle, the NEB (a non-income benefit) should not be deducted from LTD payments (an income benefit).

The Court of Appeal dismissed the appeal, holding that the 'apples to apples' principle applies to statutorily-mandated deductions from tort awards, whereas this deduction was governed by the clear and unambiguous language of the LTD insurance policy, which permitted the deduction of 'any disability benefit'.

The appellant appealed a jury trial decision dismissing her personal injury claim against the Toronto Transit Commission for an alleged fall on a bus.

She argued the trial judge erred by refusing to instruct the jury on spoliation regarding overwritten video evidence, allowing cross-examination on her doctor's complete clinical notes, and permitting references to pre-existing injuries.

The Divisional Court dismissed the appeal, finding no palpable and overriding errors in the trial judge's evidentiary rulings or jury instructions, as the appellant failed to prove intentional destruction of evidence and the medical records were relevant to her claims.

The defendant brought a threshold motion seeking a declaration that the plaintiff's personal injury claim for non-pecuniary loss was barred under s. 267.5(5) of the Insurance Act, arguing her injuries did not meet the "permanent serious impairment" threshold.

The jury had previously awarded $40,000 for general damages but no future loss of income.

The court, preferring the plaintiff's medical expert, found the plaintiff suffered from chronic pain disorder caused by the accident, constituting a permanent impairment.

While the plaintiff did not meet the employment-related impairment criteria due to successful accommodation and increased income, the court found her usual activities of daily living were seriously and permanently impaired, affecting her household management, social life, and psychological well-being.

The motion was dismissed, affirming the plaintiff met the statutory threshold.

During closing arguments in a personal injury trial, defence counsel asked the jury to consider why the plaintiff did not call her treating physician or her manager as witnesses.

The plaintiff objected and brought a motion to strike the jury.

The court dismissed the motion to strike the jury but found the comments were an inappropriate invitation to draw an adverse inference.

The court held that an adverse inference was not justified because the witnesses were not in the exclusive control of the plaintiff, given modern discovery rules that provide equal access to medical and employment records.

In a personal injury jury trial arising from a motor vehicle accident, the plaintiff moved before openings to exclude surveillance obtained by the defence after discoveries and disclosed only shortly before trial.

The court held that the defence breached rules 31.09(1)(b) and 30.07 of the Rules of Civil Procedure by failing to promptly notify the plaintiff of post-discovery surveillance and by failing to serve supplementary affidavits of documents.

Applying the leave framework under rule 53.08, the court found the prejudice did not outweigh the probative value because the trial had not yet begun in substance and any prejudice could be addressed by adjournment, costs, and immediate production of the videos.

The defence was granted leave to use the surveillance for impeachment purposes only.

In this personal injury trial arising from a motor vehicle accident, the court addressed an objection to proposed opinion evidence from a treating chiropractor on whether the plaintiff still required treatment.

Applying the framework for participant experts, the court held that treating health practitioners may give opinion evidence without rule 53.03 compliance only if the opinion was formed through observation or participation in the events at issue in the ordinary exercise of their expertise.

The court further held that a party should disclose in advance opinions to be elicited from a participant expert when those opinions are not contained in the records already produced.

A voir dire was ordered on admissibility, and any resulting prejudice was addressed by permitting the defence orthopedic expert to respond without full rule 53.03 formalities.